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Columbia  (Hntoetsttp 

College  of  igfjpgtctang  anb  ^urgeong 
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THE 


pgjrts  anir  ^jiatotos  of  |pttcal  Sstma 


AN  ADDRESS,  DELIVERED  FED.  27, 1872, 


BY 


EZRA  M.  HUNT,  M.D., 


President  of  the  Alumni  Association  of  the  College  of  Physicians 

and  Surgeons,  Medical  Department  of  Columbia  College, 

New  York  City. 


PUBLISHED  BY   OB  BEE  OF  THE  ASSOCIATION. 


NEW  YORK: 

Bradstreet  Press,  279  Broadway. 
1872. 


THE 


iftgjjte  anh  J%tofos  of  fjffokaJ  ^dmtt 


AN  ADDRESS,  DELIVERED  FEB.  27, 1872, 


EZRA  M.  HUNT.  M.D., 


President  of  the  Alumni  Association  of  the  College  of  Physicians 

and  Surgeons,  Medical  Department  of  Columbia  College, 

New  York  City. 


PUBLISHED   BY   ORDER  OF  THE  ASSOCIATION. 


NEW  YORK: 

Bradstreet  Press,  279  Broadway. 

1872. 


ADDRESS 


It  is  becoming,  my  medical  brethren,  that  as  Alumni 
of  the  College  of  Physicians  and  Surgeons,  we  should, 
year  after  year,  thus  meet  together,  to  show  our 
interest  in  the  institution  of  which  we  are  graduates, 
and  to  renew  the  professional  and  social  associations 
of  earlier  days. 

There  is  a  principle  in  our  natures  which,  when 
undisturbed  by  jealous  rivalry  or  exclusive  egotism, 
always  creates  a  bond  of  sympathy  between  those  of 
kindred  occupation,  and  there  are  special  reasons  why 
this  should  obtain  in  the  medical  profession.  The 
pursuit  of  our  science  and  the  practice  of  our  art  has 
much  in  it  that  is  toilsome,  rugged,  and  severe,  and  is 
so  separate  and  distinct  from  other  callings  that  the 
laity  cannot  be  expected  to  know  or  appreciate  its 
peculiar  exactions,  as  can  those  who  have  an  identical 
experience.  Those  not  drawn  away  by  outer  forces 
are  naturally  drawn  to  each  other.  The  companion 
in  arms  knows  best  how  to  greet  a  fellow  veteran;  and 
bound  together,  as  we  are,  in  the  same  pursuit,  it  is 
right  that  now  and  then  we  should  gather  at  the  old 
homestead  and.  like  brethren,  exchange  words  of 
common  sympathy  and  greeting. 


And  I  know  not  why  it  is  that  there  is  so  much  less 
enthusiasm  in  the  meetings  of  professional  men  in  the 
halls  from  which  they  went  forth  to  their  special  voca- 
tion in  life,  and  in  which  they  received  their  higher 
and  specific  preparation,  than  in  those  gatherings  of 
college  alumni  at  the  institution  in  which  they  received 
their  primary  and  academical  training.  It  is  not 
because  we  had  become  too  old  for  the  sympathies 
of  youth,  for  quite  beardless  and  unbent  do  we  enter 
upon  our  professional  career.  It  is  not  that  there  is 
anything  ascetic,  or  cold,  or  formal  in  our  department 
of  study.  It  is  not  that  we  do  not  become  interested 
in  our  pursuit,  in  each  other,  or  in  our  professors,  for 
as  to  each  of  these  we  have  an  enthusiasm  seldom  sur- 
passed in  academic  curriculum. 

I  think  it  mast  be  attributed  to  the  fact  that  in  our 
medical  course  we  are  less  distinctly  divided  into 
classes  ;  that  by  the  duties  of  practice  we  are  kept 
more  closely  to  the  particular  locality  in  which  we 
dwell,  and  thus,  not  meeting  with  each  other,  lose 
acquaintance  and  remembrance  ;  and  more  than  all,  to 
the  fact  that  professors  and  alumni  do  not  make  that 
effort  to  keep  up  these  associations,  which  is  made  in 
the  interests  of  collegiate  institutions.  And  pardon 
me  for  saying  that  it  seems  to  me  that  this  is  one  of 
the  things  which  we  need  to  think  of,  not  only  as  a 
personal  gratification,  but  as  a  means  of  advancing  the 
interests  of  our  calling. 

If  each  class  on  its  graduation  appointed  a  class 
secretary,  likely  to  remain  in  the  city,  through  whom 
it  could  communicate  their  localities  ;  if  in  connection 


with  each  meeting,  some  one  class,  after  ten  or  twenty 
years  of  graduation,  made  of  it  a  time  for  their  own 
special  gathering,  and  if  our  distinguished  faculty  and 
trustees  would  all  be  as  sure  to  favor  it  with  their 
presence  as  when  they  gave  us  our  diplomas,  I  believe 
it  would  result  in  substantial  benefits  to  the  College  we 
love,  and  in  the  initiation  of  an  interest  which  would 
manifest  itself  in  awakened  enthusiasm,  in  enlivened 
effort,  in  material  endowment,  and  in  a  general  pro- 
motion of  the  high  interests  of  our  Alma  Mater  in 
particular,  and  the  medical  body  as  a  whole. 

As  we  are  not  met  to-night  as  a  pathological  society, 
or  a  county  medical  society,  or  as  an  academy  of  medi- 
cine, it  will  not  be  expected  of  me  to  furnish  a  clinical 
thesis  or  medical  essay  ;  but  we  may,  perhaps,  spend 
with  advantage  a  little  time  in  taking  a  general  view 
of  the  lights  and  shadows  of  medical  life,  as  they 
vary  with  the  progress  of  the  ages  and  with  the 
changes  in  our  science,  in  order  that  we  may  see  how 
much  and  how  far  our  prosperities  exceed  our  adver- 
sities, and  what  the  superior  incitements  of  the  modern 
physician  are. 

It  is  not  concealed  from  us  that  we  live  in  times,  in 
some  respects,  particularly  trying  to  the  assiduous  and 
devoted  scholars  and  practitioners  of  our  art. 

It  is  not  to  be  expected  that  the  skepticism  and 
liberalism  of  our  day  should  confine  itself  to  disputing 
the  facts  of  science,  of  psychology,  of  theology,  etc.,  or 
that  free  thinking,  which  too  often  means  loose  think- 
ing, should  pass  us  by  without  a  visitation — and 
especially  as  our  science  affords  special  opportunities 


6 

for  the   raising  of   doubts    and    the    promulgation    of 
embarrassments . 

We  are  dependent  upon  arrays  of  facts,  upon  long 
and  careful  deductions  from  repeated  aDd  manifold 
experiences,  not  an  integral  but  a  differential  calculus, 
from  which  are  to  be  eliminated  many  sources  of  error  ; 
and  in  no  art  is  it  so  easy  to  cloud  truth  or  to  pass  off 
error  while  clad  in  its  livery.  Hence,  in  public  esti- 
mation, elegant  pretence  is  untested  and  popularity  is 
accorded  to  those  who  are  utterly  unable  to  analyse 
disease  or  skilfully  treat  those  few  cases  which  are  the 
real  tests  of  ability.  No  one  knows  so  well  as  a  con- 
scientious and  learned  physician  how  easy  it  is  for  a 
smatterer  to  palm  himself  off  on  the  popular  mind,  if 
he  only  have  address,  shrewdness,  and  a  superficial 
knowledge  ;  and  most  of  those  who  have  succeeded  in 
our  profession  are  conscious  that  had  they  combined 
with  their  real  knowledge,  more  of  the  plans  of  medi- 
cal pretense,  they  would,  pecuniarily,  have  been  abun- 
dantly more  successful. 

Hence,  we  see  how  it  is  medical  charlatans  pander 
to  the  taste  and  notions  of  the  popular  mind,  and  how 
successful  they  are  in  doing  it. 

Enormous  sums  are  expended  each  year  in  the  puff 
and  manufacture  of  patent  medicines,  most  of  which 
are  absolutely  worthless,  and  the  whole  system  of  their 
use  ignores  that  careful  study  of  the  physicians  which 
seeks  to  diagnose  the  special  ailment  of  his  patient  and 
suit  his  remedy  to  the  person  and  the  disease.  How 
these  "hang  their  banners  on  the  outer  walls;"  how 
every  fence,  and  corner,  and  railroad  outlook,  and  tree, 


and  rock,  is  plastered  and  inscribed,  so  that  one  can 
scarce  get  hold  of  a  fossil  from  California  not  labelled 
vinegar  bitters,  or  a  rock  of  the  Palisades  without  an 
inscription  of  soothing  syrup.  How  artists  and  poets, 
and  theological  doctors  lend  their  names  and  influence 
to  whole  systems  of  irregular  practice,  which  rest  on 
a  course  of  argument  that  would  upset  theology  if  it 
did  medicine,  and  how  the  learned  physician  has  occa- 
sion to  feel  almost  ashamed  of  himself,  and  disgusted 
with  his  profession,  when  he  sees,  not  only  the  igno- 
rant masses,  but  some  of  those  who  aspire  to  be  leaders 
of  society,  lending  themselves  to  the  support  of  princi- 
ples they  have  never  investigated,  and  of  practice  they 
have  never  tested,  except  in  the  narrow  circle  of  self- 
diseased  infliction. 

How  often  do  we  see  those  who  make  a  great  pro- 
ficiency in  their  own  calling,  when  they  come  to  the 
science  of  medicine  "so  uninformed  as  to  be  incapable 
of  appreciating  their  own  ignorance  of  what  we  know.?; 

Says  a  recent  writer  (Rev.  Dr.  Atwater,  April,  1871), 
in  the  Princeton  Review  :  "Medical  practice  is  largely 
of  such  a  nature  that  it  is  not  like  nearly  all  other 
professions,  capable  of  being  passed  upon  by  compe- 
tent judges.  The  professional  practice  of  clergymen 
and  lawyers,  and  in  nearly  all  other  professions,  is  in 
itself,  or  its  results,  in  the  presence  of  those  competent 
to  judge  of  its  merits,  and  capable  of  knowing  whether 
it  betrays  inexcusable  ignorance  or  culpable  negligence. 
But  not  so  with  the  physician.  How  is  it  possible  for 
ninety-nine  in  a  hundred  of  his  patients  to  know  about 
his  medicines,  their  nature,  efficacy,  or   adaptation  to 


8 

the  case  for  which  they  are  prescribed?  And,  in  case 
of  recovery,  or  a  fatal  issue,  how  impossible  is  it  for 
most  of  them  to  know  it  was  by  the  help,  or  in  spite, 
of  the  doses  administered  ?  This  is  what  facilitates 
the  prodigious  success  of  quacks  and  makers  of  nos- 
trums and  panaceas  in  this  profession.  The  manufac- 
ture of  patent  medicines  is,  next  to  the  seizure  of  great 
railroad  franchises,  or  the  ingenious  robbery  by  stock- 
watering  and  plundering,  the  surest  road  to  coarse  and 
ostentatious  opulence  afforded  in  our  country.  And  if 
the  prince  of  railway  robbers  and  gamblers  dazzles  the 
fashionables  at  watering-places  with  four-horse  turn- 
outs, gayly  caparisoned,  the  prince  of  patent  medicine 
quacks  eclipses  him  with  six  studs  and  proportional 
attendants,  all  agiare  and  ablaze  with  trappings  not 
less  brazen  and  gilt  than  their  owner.  While  these 
features  of  medical  practice  tempt  vast  numbers  of 
practitioners  to  neglect  the  study  necessary  to  keep 
them  abreast  of  the  times,  and  acquainted  with  the 
ever-varying  forms  of  disease,  with  discoveries  in 
materia-medica,  and  details  of  practice  :  on  the  other 
hand  we  rank  among  the  noblest  of  our  professional 
men,  those  many  physicians  who  surmount  these  temp- 
tations to  indolence  and  ignorance. 

"The  studious  physicians  of  our  own  and  past  days 
belong  to  the  highest  order  of  intellectual  men.  Al- 
though, outside  of  the  profession,  we  are  free-to  con- 
fess that  no  kind  of  literature  whatever  impresses  us 
more  strongly  with  the  ability,  the  culture,  the  dis- 
crimination in  thought  and  mastery  of  style,  than  the 


higher  class  of  medical  books  ;  especially  the  standard 
treatises  on  medical  practice. 

"We  well  recollect  hearing  the  late  Dr.  J.  Addison 
Alexander  (and  there  could  be  no  higher  authority  in 
such  matters)  express  his  wonder  at  the  power  of 
style  of  the  standard  medical  writers,  and  lamenting 
the  comparative  inferiority  and  helplessness  of  other 
professions  in  this  respect." 

The  incidental  testimony  of  such  men  may  well 
inspire  us  to  increased  enthusiasm. 

Again,  we  cannot  but  recognize  that  the  study  of 
the  science  and  the  practice  of  the  art  of  medicine  is 
fraught  with  many  real  and  intrinsic  embarrassments. 
It  involves  investigation  of  the  most  precise  and  astute 
character.  It  is  not  merely  a  science  but  a  family  of 
sciences,  from  a  knowledge  of  which  is  to  be  deduced 
rules  regulating  the  period  of  human  life,  and  dealing 
with  all  those  oscillations  and  variations  from  internal 
or  external  forces  to  which  man  as  a  machine,  as  a 
mind,  is  subjected. 

Having  mastered  one  disease,  a  hundred  more  are 
waiting  for  analysis ;  having  relieved  one  patient, 
the  very  next  one  that  presents  himself  may  have  a 
totally  diverse  complication  and  obscurity  of  disease 
calling  for  the  highest  perfection  of  knowledge  and 
experience  in  a  different  line,  while  judgment,  that 
highest  quality  of  mind,  that  condensed  and  resultant 
abstract  of  all  knowledge,  must  ever  be  on  its  balance, 
that  it  may  see  what  is  to  be  thrown  in  each  side 
of  the  scale  and  how  the  equilibrium  of  life  is  to  be 
maintained. 


10 

The  general  practitioner  is  called  upon  to  investigate 
departments,  any  one  of  which  is  full  study  for  a  life- 
time, and  has  to  do  with  a  range  of  physical  and  psy- 
chical laws,  with  studies  of  relations  of  cause-  and 
effect — of  disease  and  remedies — enough  either  to  appal 
the  stoutest  heart,  or  to  lead  one  with  heroic  determi- 
nation to  put  on  the  armor  and  endure  hardness  as 
destined  to  achieve.  And,  often,  there  must  not  only 
be  decision,  but  quick  decision ;  not  merely  a  cool  de- 
termination of  methods,  but  an  actual  application  of 
them  with  celerity,  or  else  the  patient  is  gone  while 
the  decision  is  pending,  or  its  results  are  unapplied. 
I  know  of  no  profession  in  which  there  is  more  need 
of  that  thorough  previous  discipline  of  mind  which  de- 
velops the  reasoning  powers,  and,  at  the  same  time, 
cultivates  the  love  of  patient  investigation  and  labori- 
ous research,  by  which  experiment  can  be  followed  up 
and  followed  out  until  it  ripens  into  established  facts 
and  practical  experience. 

It  is  well  for  us  not  only  to  be  aware  from  the  start, 
but  to  remind  ourselves  all  along  our  medical  practice, 
that  the  task  we  have  undertaken  is  a  very  difficult 
one — to  admit  that  our  art  has  manifold  uncertainties, 
just  because  metaphysics  and  natural  philosophy  have 
manifold  uncertainties.  But,  admit,  too,  that  conscious 
of  these  facts,  we  are  also  conscious  that  there  are 
basic  and  immutable  principles  on  which  to  operate  ; 
and,  admit,  too,  that  we  intend  to  follow  them  up  and 
follow  them  out,  until  one  after  another  mere  hypo- 
theses are  eliminated  and  real  facts  established. 

That  is  what  makes  any  science  a  real  science,  and 


11 

any  art  a  real  art ;  and  difficulties  and  embarrassments 
do  not  involve  permanent  uncertainty  as  to  results,  so 
long  as  we  recognize  them  and  prepare  ourselves  to 
deal  with  them. 

In  fact,  the  profounder  any  study  is,  the  grander  is 
its  pursuit,  if  so  be  it  has  some  well-ascertained  prin- 
ciples, and  by  its  past  practical  application,  and  by 
success  in  discerning  its  bases,  we  have  assured  our- 
selves that  progress  and  definiteness  is  attainable. 

Any  experimental  science  does  not  reach  its  climax 
with  the  quickness  of  mathematical  or  demonstrative 
reasoning,  but  yet  we  are  to  know  that  experiment 
makes  the  word,  and  the  fact  experience  ;  and  that 
experience  arrives  at  certainties  which  are  not  pre- 
sumptive in  placing  themselves  alongside  of  the  con- 
clusions of  Mental  and  Moral  Philosophy,  and  the  de- 
lineations of  a  mathematical  problem. 

All  of  our  Natural  Philosophy  rests  on  just  such  a 
substructure ;  and  yet  Newton  is  as  sure  as  Euclid,  and 
Faraday  as  positive  as  McCosh. 

With  this  hasty  glance  at  some  of  the  real  embar- 
rassments of  our  calling,  we  pass  on  to  inquire  what 
are  the  chief  incitements  of  the  Modern  Physician 
which  encourage  him  in  grappling  with  real  difficul- 
ties— in  contending  with  quackery  and  in  practising 
an  art  as  to  which  his  well-meaning  patients  are 
often  skeptical  because  necessarily  uninformed. 

We  answer,  1st.  In  the  increasing  definiteness  as  to 
our  knowledge  and  its  applications. 

If  we  but  compare  the  status  of  our  profession  to- 
day, and  the  sources  of  its  information,  with  what  ob- 


12 

tained  in  the  years  that  are  past,  we  have  the  most 
abundant  reason  to  congratulate  ourselves  on  what  has 
been  secured. 

Sir  Thomas  Watson,  in  a  recent  edition  of  his  Prac- 
tice, says:  "  Considering  the  rapid  advance  of  medical 
science  during  the  last  fourteen  years,  the  present 
edition  would  be  worthless  if  it  did  not  differ  from  the 
last." 

Compare,  if  you  will,  the  anatomy  of  the  old  doc- 
tors, who  supposed  the  arteries  to  be  air  tubes,  and 
knew  as  little  of  the  circulation  of  the  blood  as  we  do 
now  of  the  development  theory  of  creation,  with  that 
exact  knowledge  by  which  we  know  not  only  the 
organs  and  media  of  circulation,  but  the  pneumatic 
and  hydrostatic  principles  which  govern  it — the  nature 
of  valvular  action,  etc. 

What  an  advance  on  alchemy,  with  its  elixer  cru- 
cible and  its  unguarded  experiments,  are  the  wonder- 
ful developments  of  modern  chemistry ! 

What  a  change  from  the  crude  remedies  of  by-gone 
days  to  the  well-defined  action  of  elegant  extracts  ! 
Sir  Thomas  Browne  in  the  introduction  to  his  Religio 
Medici,  excuses  his  disconnected  thoughts,  by  the  fact 
that  when  he  was  in  the  midst  of  study,  he  was  often 
drawn  aside  and  perplexed  by  the  necessities  of  uris- 
copsy.  Imagine  the  doctor  with  no  tests,  no  reactions, 
no  microscope,  attempting  to  draw  deductions  as  to 
treatment,  and  compare  it  with  the  real  advantage 
definite  knowledge  now  gives. 

Of  Paracelsus,  the  great  physician  and  chemist  of  his 
age,    Fleming   in  his  Philosophy   says,    "that  he   be- 


13 

longed  to  a  school  who  mixed  enthusiasm  with  obser- 
vation, alchemy  with  theology,  metaphysics  with 
medicine,  and  clothed  the  whole  with  a  form  of 
mystery  and  inspiration."  Old  Fare  considered 
Ranula  ;'as  cold,  moist,  gelatinous  matter,  derived 
from  the  brain  and  transplanted  to  the  tongue." 
In  fact,  as  to  Physiology,  Pathology,  Histology, 
Materia  Medica,  G-ynsecology,  Physical  Exploration, 
Qualitative  Analysis  and  Hygiene,  we  are  all  aware 
how  much  they  are  the  outgrowth  of  very  modern 
investigation.  Now,  Pence  Jones  published  a  large 
octavo  ';on  the  applications  of  Chemistry  and  Me- 
chanics to  Pathology  and  Therapeutics,"  and  so  Car- 
penter "  on  the  Microscope  and  its  Revelations,"  and 
thus  we  have  whole  octavos  on  single  subjects  in  mani- 
fold departments.  In  fact,  there  are  doctors  living 
who  have  seen  the  one  science  of  medicine  like  a 
cactus  or  Rhododendron — once  only  enough  of  char- 
acter and  distinctiveness  to  claim  to  be  a  species — now 
blooming  right  out  with  clusters,  each  admirable  in 
itself,  and  together  entwining  into  a  garland,  which 
pronounces  its  possessor  a  victor  in  his  struggle  for 
mastery  over  disease. 

Nor  is  our  success  alone  in  what  has  actually  been 
attained.  Advance,  in  any  science  or  art,  consists  not 
less  in  knowing  how  to  learn  what  we  do  not  know, 
than  in  actual  knowledge  already  secured.  Bacon  and 
Newton  did  not  so  much  for  philosophy  by  what  they 
themselves  discovered,  as  by  giving  prominence  to 
methods  of  investigation,  which  served  as  a  key  to 
unbar  many  a  combination  lock. 


14 

So  long  as  men  undertook  to  determine  the  facts  of 
Nature  by  assuming  laws,  and  then  reasoning  from 
them  in  the  a  priori  method,  there  were  intrinsic  and 
vital  embarrassments  to  the  progress  of  medicine  as  a 
science,  and  hence  to  its  classification  as  an  art.  But, 
so  soon  as  the  method  of  induction  had  secured  gen- 
eral recognition,  and  come  to  be  felt  as  legitimate  a 
mode  of  arriving  at  truth  as  the  mathematical  or 
logical  system,  just  so  soon  it  became  certain  that  our 
science  had  received  an  impetus  that  would  result  in 
the  most  important  accessions  to  its  practical  applica- 
tions. No  longer  would  it  be  the  business  of  the 
physician  to  be  an  Esculapius,  amid  disjointed  and 
venturesome  experiments  seeking  for  specifics,  or,  a 
Gralenist  contending  against  all  the  chemists  ;  or,  even 
a  Hippocrates  dealing  in  aphorisms,  which,  at  best, 
could  be  but  shrewd  guesses  at  truth.  Now,  not  only 
from  causes  could  he  seek  effects,  but  from  effects 
with  which  we  are  always  the  more  familiar,  he  was 
taught  that  it  was  legitimate  to  look  for  causes. 
Hence,  at  once,  he  was  to  become  a  great  fact- 
gatherer — a  great  observer  ;  not  merely  empirically 
to  seek  a  remedy,  but  still  more  to  infer  from  his  facts 
and  symptoms  those  reliable  laws  which  cause  the 
result  he  sees,  and  so  to  arrive  at  general  principles 
which  underlie  the  system,  and  enable  us  not  only  to 
account  for  this  or  that  phenomenon  but  to  interpret 
and  investigate  whole  chains  and  series  of  occurrences 
in  health  and  disease. 

He  now  can  go  to  work,  not  merely  to  collect  the 
facts  which  make  knowledge,  but  "to  understand  the 


15 

laws  by  which  the  facts  of  experience  are  determined," 
and  so  to  make  science,  which  is  knowledge  utilized; 
which  not  only  knows  what  has  happened,  but,  having 
comprehended  the  law,  knows  what  will  happen  ; 
knows  the  bearing  of  facts  one  upon  another,  and  thus 
stands  by  the  bed-side  as  it  does  in  the  labratory  or 
dissecting  room,  knowing  what  symptoms  mean,  and 
even  what  other  symptoms  will  occur,  and  what  they, 
too,  will  denote.  Now,  it  is  interesting  to  notice  how 
this  method,  born  in  our  century,  had  its  procession  of 
application. 

Commencing  with  astronomy  and  the  law  of  gravi- 
tation, it  soon  advances  to  physics  in  general,  but 
specially  to  chemistry  and  the  laws  of  growth  and 
structure,  and  comes  even  to  be  applied  to  meta- 
physics and  theology. 

Medicine,  as  a  department  of  physics,  was  entitled 
to  propulsion  at  once  ;  but,  there  was  the  crudity  of 
former  systems,  the  stubborn  adhesion  to  systems  of 
empiricism,  which  thought  themselves  science,  and 
practical  at  that,  and  scouted  new  methods  as  hypo- 
thetical and  absurd. 

Then,  there  was  need  that  such  sciences  as  chemistry, 
botany,  and  the  laws  of  structure,  growth,  waste  and 
repair,  et  caetera,  as  applied  to  other  departments  of 
Nature,  should  be  investigated  first  in  their  own  indi- 
vidualities as  sciences.  Says  Whewell :  "Medicine 
in  its  original  and  comprehensive  sense,  as  one  of  the 
great  divisions  of  human  culture,  must  be  considered 
as  taking  in  the  whole  of  physical  science." 

In  due  time,  man,  the  greatest  marvel  in  this  work- 


16 

shop  of  Nature,  would  not  escape,  and  the  physician 
who  was  to  be  the  scientist  of  this  department,  would 
not  be  asleep  in  his  professorship  any  more  than  the 
physicist  would  be  in  his.  "If,"  says  J.  S.  Mill, 
"  there  is  anything  that  deserves  to  be  studied  by  man, 
it  is  his  own  nature  and  that  of  his  fellow  men  ;  and, 
if  it  is  worth  studying  at  all,  it  is  worth  studying 
scientifically." 

And,  one  after  another  medical  men  began  to  accept 
that  situation  ;  one  and  another  caught  the  gleamings 
of  the  light  as  the  hills  catch  the  gleamings  of  the  day, 
and  started  out  on  this  method  of  work.  And  the 
men  are  yet  living  and  have  been,  or  are  our  precep- 
tors, who  were  thus  pioneers  in  whole  departments  of 
physical  science  relating  to  man — searching  for  matters 
of  fact  in  the  human  organism  in  health  and  disease, 
scrutinizing  these  facts  as  never  before  facts  in  our 
department  were  scrutinized — because  the  facts  were 
the  direct  and  close  posterity  of  great  ancestries  of 
principles,  the  understanding  of  which  would  preserve 
and  elevate  the  posterity  of  humanity. 

And  if,  in  any  one  department  of  science  more  than 
another,  there  has  been  for  the  last  thirty  years  dili- 
gent collection,  classification,  and  comparison  of  facts, 
and  careful  and  tested  deduction  of  laws  therefrom,  it 
has  been  in  this  science  of  medicine. 

No  pursuit  is  more  exacting  in  its  demands  that 
experiments  shall  be  tested  over  and  over  again  before 
they  are  admitted  as  facts,  and  the  medical  philosopher, 
having  ascertained,  beyond  question,  the  facts,  then 
goes  to  work  to   interpret  their  language,  and   from 


17 

them  to  deduce  those  laws,  some  of  which  have  already, 
by  their  brilliant  and  vital  life-saving  deductions,  raised 
our  study  to  noble  heights  of  scientific  excellence. 
Those  who  have  been  unwilling  to  make  of  medicine 
so  much  of  a  study,  observation,  and  toil,  have  been 
wont  to  discard  or  to  depreciate  the  value  of  such  work  ; 
but  theory  and  practice  have,  by  actual  results,  proven 
themselves  to  be  so  interwoven,  that  one  would  now 
as  soon  be  a  weaver  without  the  web  as  to  be  a  doctor 
without  seeking  to  interweave  his  facts  with  the  foun- 
dations of  facts,  and  thus  to  be  an  observer  of  princi- 
ples as  well  as  of  symptoms. 

The  last  few  years  have  shown  bases  of  deduction 
and  evolved  principles  of  investigation,  which  we  know 
to  be  fraught  with  weightiest  results  in  their  influence 
upon  the  practical  advancement  of  our  profession. 

The  whole  system  of  Histology  and  the  methods  of 
investigating  pathological  changes  apply  to  the  study 
of  whole  ranges  of  truth.  By  methods  of  exclusion, 
disease  is  often  actually  ciphered  down  so  as  to  present 
a  problem  numbered  like  a  proposition  of  geometry, 
and  then  we  go  at  it  with  accumulated  facts,  with 
clinical  experiences,  so  as  still  further  to  eliminate 
questions  as  to  type  and  tendency,  so  that  the  "I 
know,'7  takes  the  place  of  the  "  I  think,"  and  whatever 
may  be  the  result  the  doctor  knows  his  treatment  to 
be  a  constant  protest  against  the  tendencies  of  the 
disease.  In  fact,  the  most  embarassing  thing  now-a- 
days,  to  the  conscientious  practitioner,  is  in  a  given 
critical  case,  to  know  that  a  saving  amount  of  knowl- 
edge is  secured  as  to  the  disease  in  question,  and  yet, 


18 

by  reason  of  the  variety  and  multiplicity  of  his  duties, 
he  is  not  able  to  secure  it.  ' '  Fools  rush  in  where 
angels  fear  to  tread  ;"  but  the  busy  general  practi- 
tioner often  feels  that  he  would  like  to  be  a  thoroughly 
posted  specialist  on  every  class  of  cases  coming  under 
his  eye. 

Now-a-days  more  is  to  be  feared  from  the  imperfec- 
tions of  personal  knowledge,  i.  e.,  from  the  uncertain- 
ties of  doctors  than  from  the  uncertainties  of  medicine. 

Never  was  there  a  day  when  a  patient  needs  to  be 
so  much  afraid  of  superficiality  .or  half  knowledge,  or 
so  reliant  upon  full-trained  skill. 

Of  nothing  else  is  it  so  true  now  as  of  medical 
science,  "that  a  little  learning  is  a  dangerous  thing.77 

To-day  I  was  looking  at  the  post-mortem  photograph 
of  a  deceased  friend,  taken  by  an  eminent  artist,  and 
it  was  so  perfect,  so  life-like,  that  I  said  to  myself, 
what  an  art  is  this  !  what  exactness  !  what  perfection ! 
How  every  line  of  the  face  is  distinct,  how  the  Yery 
eye,  not  statue -like,  but  life-like,  looks  at  me  as  if  with 
living  retina. 

Having  occasion  to  consult  Niemeyer  and  Yogel  the 
same  day,  as  to  some  cases  of  disease,  so  clinical,  so 
vivid,  so  exact  was  the  description,  that  I  could  not 
but  say,  "Well,  here  too  I  have  a  photograph,  and  if 
one  art  is  wonderful  so  is  the  other."' 

We  have  reason,  also,  especially  to  congratulate  our- 
selves upon  the  wonderful  helps  that  mechanics  and 
collateral  science  have  afforded  to  our  department  of 
study.  The  microscope  itself,  with  its  constantly  in- 
creasing uses,  and  its  wonderful    perfection,   has    not 


19 

only  opened  a  new  field  for  investigation,  but  has 
enabled  us  to  study  cause  and  effect,  and  disease  in 
its  remedies  and  results,  in  such  a  way  as  may  well 
excite  enthusiastic  zeal. 

A  crude  artist,  to  whom  Reynolds  was  once  exhibit- 
ing a  picture,  said,  "  Mr.  R.,  with  what  paints  did  you 
execute  this?'7     "With  brains,  sir,"  was  the  reply. 

And  so  the  physician,  to-day,  when  asked  how  he 
discovered  this  or  that  disease,  can  reply,  '•  With  eyes, 
sir  ;"  not  mere  human  eye,  but  lenses  a  thousand-fold  ; 
looking  not  alone  far  as  the  eye  can  reach,  but  as  if 
the  film  between  the  finite  and  infinite  were  couched, 
and  human  dimness  brightened  into  unrestrained  per- 
ception. 

And  so  with  the  layrngoscope,  the  spectroscope, 
the  opthalmascope,  the  apparatus  for  micro-photo- 
graphy, etc. 

Prof.  Grairdner,  in  a  recent  lecture  in  Edinburgh 
University,  says  :  "  From  the  evident  care  for  scien- 
tific training,  in  the  University  of  Berlin,  and  the 
number  and  character  of  the  men  who  are  found 
to  devote  themselves  to  experimental  researches  of 
a  difficult  and  not  directly  remunerative  order  ;  from 
the  facilities  given  to  such  researches,  in  the  ana- 
tomical, physiological,  chemical,  and  pathological  de- 
partments, under  the  direction  of  the  various  pro- 
fessors ;  with  the  liberal  grants  for  rooms,  apparatus, 
and  materials  ;  I  came  away  convinced  that  medical 
science  and  scientific  training,  which  are  unhappily 
in  danger  of  being  starved  in  England  and  Scot- 
land, thereby  cutting  away  from  the  practical  depart- 


20 

ment  the  staff  on  which  they  ought  to  lean,  are 
fostered  in  the  German  universities  as  the  very  life 
and  light  of  medical  art.  In  almost  all  our  medical 
schools,  in  this  country,  we  greatly  need  a  physio- 
logical and  pathological  laboratory,  where,  in  close 
connection  with  the  hospital,  the  work  of  instruction 
in  the  analysis  of  the  human  or  animal  body,  its  secre- 
tions and  excretions,  normal  and  pathological,  may  be 
constantly  carried  on  in  public  and  private  classes,  and 
where,  besides  investigations  into  the  properties  of 
remedies  and  poisonous  substances,  investigations  such 
as  those  brilliant  ones  of  Liebreich  on  the  properties 
of  chloral-hydrate  may  be  systematically  pursued.'' 

And  in  view  of  the  progress  already  made,  and  of 
the  methods  already  perfected  for  new  and  more  ex- 
haustive investigation,  and  of  the  vast  amount  of  knowl- 
edge viable,  but  not  }*et  sprung  from  the  brain,  is 
there  not  a  call  upon  the  physicians  of  our  land  to 
provide  a  school  of  medical  science,  having  higher  aims 
and  giving  greater  facilities  than  any  now  upon  our 
Western  continent. 

We  are  not  proposing  that  there  should  be  any 
specially  new  methods  of  instruction,  so  far  as  the 
college  curriculum  is  concerned,  but  what  we  do  wish 
to  see  is  a  higher  school,  which  shall  be  ready  to 
receive  all  those  who,  by  diligence  or  competitive  exami- 
nation, entitle  themselves  to  farther  pursuit  and  enable 
them,  under  favorable  circumstances,  to  pursue  medi- 
cine and  its  collateral  sciences,  so  as  to  arrive  at  fuller 
knowledge  of  those  great  truths  and  facts  which  underlie 
the  study  of  all  that  is  human  and  material  in  man. 


21 

If  your  attention  has  not  been  turned  to  it,  you 
would  be  surprised  to  find  the  change  which  has  taken 
place,  among  young  men,  in  the  grasp  for  medical 
knowledge,  in  our  own  country,  within  the  last  twenty 
years.  A  far  greater  number  than  formerly  of  the 
members  of  our  best  medical  colleges  have  had  a 
previous  collegiate  training,  and  although  the  study  of 
medicine  is  very  far  more  expensive  than  that  of  law 
or  theology,  yet,  I  am  told,  that  not  over  one-third  of 
those  who  graduate  from  this  institution,  for  instance, 
go  directly  into  private  practice.  Having  expended 
one  thousand  or  twelve  hundred  dollars  more  than  has 
the  theologian  or  lawyer  in  his  preparation,  they  are 
willing  to  spend  one,  two  or  three  years  more  before 
even  seeking  a  locality.  Besides  the  numbers  who  go 
to  our  own  hospitals  or  to  private  infirmaries  or  spe- 
cialties, from  fifty  to  sixty  are  to  be  found  at  Berlin  or 
Vienna,  and  many  more  in  some  of  the  French  or  En- 
glish schools. 

Now  this  very  fact  is  a  noble  warranty  for  the 
founding  of  an  institution  that  shall  deal  only  with 
graduates  of  medical  colleges,  admitting  them  to 
special  courses,  giving  the  highest  advantages  for  pa- 
thological and  physiological  investigation,  for  the  stu- 
dies of  the  laboratory  and  for  all  those  departments 
which  must  necessarily  be  studied  in  this  way  before 
entering  upon  practice,  if  the  highest  skill  will  be 
secured. 

Hospitals,  as  at  present  constructed,  are  not  suffi- 
cient for  those  purposes,  and,  while  visitation  and  as- 
sociation with  them  is  important  as  collateral  to  such  a 


22 

plan,  it  in  nowise  accomplishes  the  same  result.  And 
I  look  forward  with  hopefulness  to  the  day  when  our 
wealthy  physicians  will*  feel  it  their  privilege  to  pro- 
vide some  such  facilities  ;  when  oar  professors,  while 
receiving  their  full  pay  for  college  duties,  will  be  will- 
ing to  give  to  their  own  kith  and  kin  such  gratuitous 
help  in  this  line,  as  they  now  give  to  the  public  by 
their  attendance  on  public  institutions,  and  then  the 
American  student  may  have  afforded  such  opportuni- 
ties as  shall  place  our  profession  in  the  very  first  rank 
of  the  sciences,  and  it  may  be  that  some  munificent 
lay  philanthropist,  for-  the  cause  of  humanity,  will 
endow  some  such  institution. 

As  dealing  with  human  health  and  happiness,  as 
conserving  the  highest  material  interests  of  society,  it 
is  entitled  to  the  fostering  care  of  the  government,  even 
under  republican  institutions,  and  if  only  the  facilities 
are  provided,  the  medical  profession  will  not  be  slow 
in  giving  evidence  of  an  enthusiasm  whose  results  will 
accumulate,  not  only  in  addition  to  the  great  amphi- 
theatre of  science,  but  to  the  still  grander  arena  of 
art — of  that  art  which  teaches  the  preservation  of 
health,  which,  when  this  fails,  grapples  with  the  ady- 
namic tendency  of  disease,  and,  when  this  effort  fails, 
soothes  and  comforts  the  pains  and  struggles  of  suffer- 
ing and  dying  fellow  men. 

Only  thus  can  we  have  full  scope,  for  to  get  experi- 
ence we  must  have  experiment — we  must  have  this 
kind  of  investigation.  Books  are  good,  but  they  have 
not  as  full  a  relation  to  our  profession  as  to  the  others, 
but  only  give  us  clinical  advantages,  and  these  other 


23 

advantages,  and  we  will  consecrate  ourselves  still  more 
to  this  noble  philanthropy,  and  show  to  the  world 
that  we  will  not  only  contend  against  the  effects,  but 
so  dry  up  the  sources  of  disease  as  to  make  the  average 
man,  and  the  average  woman,  and  the  average  child, 
of  the  twentieth  century,  an  improvement  upon  those 
of  the  nineteenth. 

Our  system  of  development,  though  it  be  not  Dar- 
winian, shall  bring  us  nearer  back  to  the  idea,  "  In  the 
image  of  G-od  made  He  him.'7 

I  know  there  are  those  who  talk  so  much  about  the 
practical,  and  even  the  clinical,  as  rather  to  underrate 
some  of  the  scientific  research  of  medicine,  and  mean 
by  collateral  something  very  subsidiary,  but  to  learn 
how,  and  what  to  investigate,  requires  something  else 
than  mere  presence  amid  disease,  and  I  am  glad  to 
know  that  the  discoveries  of  the  last  few  years  have 
shown  more  than  ever  before  the  intimate  relation 
between  medical  science  and  successful  practice. 

Even  when  the  persons  pursuing  in  this  way  do  not, 
from  lack  of  time  or  fondness  of  study,  themselves 
become  skilled  or  noted  practitioners,  they  are,  never- 
theless, the  men  who  kindle  for  us  the  watch-fires,  and 
light  the  signal-  torches,  and  enable  us  to  use  the  light 
and  radiance  they  evolve  for  insight  into  disease,  and 
for  bringing  to  the  light  the  hidden  things  of  disease, 
that  that  which  is  "  turned  out  of  the  way  may  rather 
be  healed." 

''The  observation  of  phenomena/'  says  Cooke, 
"  must  always  be  the  occupation  of  the  great  mass  of 
scientific  men."     To  none  does  this  apply  more  than 


24 

to  the  physician.  But  the  phenomena  are  only  partly 
clinical,  and  beside  the  recorded  experience  of  the 
busy  practitioner,  we  need  also  the  recorded  expe- 
rience of  the  scientist  who  has  more  leisure  for  dissec- 
tion, analysis,  study,  or  microscopy  ;  for  all  the  colla- 
teral aids  which  are  now  so  enriching  the  science  and 
the  art  of  our  profession. 

Another  of  the  incitements  to  the  modern  physician 
is  the  bearing  which  our  profession  has  upon  the  moral 
elevation  of  society. 

It  is  not  merely  man,  the  animal,  which  comes  under 
the  cognizance  of  the  physician.  Herbert  Spencer  has 
said,  "  that  the  first  thing  to  do  with  a  man  is  to  make 
him  a  good  animal  ;?;  and  so,  if  this  were  true,  it 
would  be  no  inferior  calling,  but  the  intellectual, 
moral,  social,  civil,  all  that  makes  a  man,  is  interwoven 
amid  the  duties  of  our  art. 

Not  to  speak  of  those  advantages  for  moral  influ- 
ences which  we  enjoy  by  reason  of  our  intimate  inter- 
mingling with  the  homes  of  the  world's  people,  the 
relations  of  hygienic  and  sanitary  conditions  to  the 
elevation  of  moral  status  are  now  too  plain  to  be  re- 
garded as  any  longer  latent. 

The  longing,  for  instance,  for  "  ardent  stimulus"  in 
low  and  crowded  districts  is  a  real  call  of  nature  for 
some  temporary  vitalizer  to  counteract  the  depression 
of  foul  air  and  filth,  and  Chadwick  was  right  when  he 
proposed  and  demonstrated  the  building  of  good  tene- 
ment houses  in  good  districts  as  a  method  of  drying 
up  the  fountain  of  crime. 

Every  new  advance  in  our  science  more   and  more 


25 

demonstrates  disease  as  the  result  of  sin — of  a  disre- 
gard of  those  high  organic  laws  which  underlie  the 
relation  of  men  to  each  other  and  to  the  world  in 
which  they  dwell — and  in  helping  the  physical  status 
of  the  world,  nowise  indirectly  are  we  helping  the 
metaphysician  and  the  Christian  in  their  attempts  to 
liberate  reason  from  the  domain  of  illusion  and  bad 
logic,  and  conscience  from  the  domain  of  perverted 
morals.  The  solving  of  the  great  problems  of  life  in 
manifold  aspects  must  submit  to  our  handling — nay, 
more,  the  physician  is  the  very  one  who  most  natu- 
rally and  properly  collects  and  compares  the  testimony 
of  collateral  sciences  and  sits  as  fittest  judge  on  the 
great  questions  of  humanity. 

Commerce  waits  with  earnestness  for  our  verdict  as 
to  the  cause  and  course  of  epidemics.  The  great  inter- 
ests of  insurance  ask  us  how  to  adjust,  in  proper 
balance,  the  probabilities  and  possibilities  of  disease. 
The  jurist,  more  than  ever  before,  is  on  the  alert  to 
detect  the  bearing  of  medical  science  on  human  juris- 
prudence, and  it  is  wonderful  to  see  how  great  inter- 
ests of  legislation,  not  only  those  of  crime,  but  those 
for  the  prevention  of  crime — for  all  that  relate  to  the 
welfare  of  the  citizen,  is  beginning  to  feel  the  wand 
and  the  tactile  touch  of  medical  facts  and  principles. 

Education  is  putting  to  us  endless  queries  as  to  mind 
and  body  culture,  and  I  have  heard  the  opinion  ven- 
tured that  fifty  years  more  will  see  medical  men  looked 
to  as  the  great  educators  and  authorities  for  methods 
of  education,  because  of  the  bearing  of  great  physiolo- 
gical, psycological  facts  upon  this  whole  subject. 


26 

And  theology  itself,  how  it  begins  to  look  to  the 
position  of  medical  science  and  the  views  of  medical 
men.  Why,  you  cannot  take  up  a  treatise  on  sys- 
tematic theology,  such  as  the  recent  one  of  Hodge,  for 
instance,  without  finding  the  names  of  medical  men 
scattered  over  its  pages,  and  their  views  discussed  and 
their  opinions  quoted  with  a  deference  or  with  a 
seriousness  that  shows  how  outreaching  and  inter- 
penetrating are  the  great  investigations  of  the  medical 
mind. 

The  reasonings  of  Hartley.  Priestly.  Carpenter. 
Mayer,  Lionel  S.  Beale,  Dalton,  Dr.  H.  B.  Jones,  Dr. 
Maudsley,  and  others,  are  as  explicitly  discussed  as 
those  of  Comte,  Cousin,  Spencer,  or  Sir  William 
Hamilton. 

In  fact,  when  I  see  what  has  been  attained  in  the 
last  quarter  century  of  our  science,  and,  still  more, 
when  I  see  that  what  we  are  handling  is  the  sure  ;>  open 
sesame"'  to  greater  and  grander  and  more  practical 
discoveries  than  have  yet  illustrated  our  science  and 
practicalized  our  art,  I  feel  more  what  old  Sir  Thomas 
Brown  has  said,  "We  carry  with  us  the  wonders  we 
seek  without  us.  There  is  all  Africa  and  her  prodigies 
in  us.  We  are  that  bold  and  adventurous  piece  of 
nature  which  he  that  studies  wisely  learns  in  a  com- 
pendium what  others  labor  at  as  a  divided  piece  and 
endless  volume/'  What  were  his  glimpses  we  see 
with  lenses  so  magnified  and  the  objects  so  near,  that 
anticipation  breaks  into  enthusiasm,  and  as  all  the 
while  we  are  entering  into  the  possession  of  great 
stores  of  scientific  wealth  ;  the  rich  ranges  of  truth  we 


27 

see  in  the  short  distance  are  already  lighted  by  the 
rays  that  strike  against  them  from  the  light  and  cen- 
tres already  opened.  Into  these,  those  who  come  after 
are  sure  to  dig  and  delve  until  they  bring  out  precious 
ores  of  life-saving  and  health-guiding  truth.  Our  clear 
college  here  has,  we  know,  something  of  this  zeal.  Said 
a  member  of  a  theological  seminary  in  this  city  to  me 
recently:  "  I  once  in  a  while  drop  into  a  lecture  in  the 
College  of  Physicians  and  Surgeons  to  feel  the  thrill  of 
that  enthusiasm  with  which  its  professors  lecture  and 
its  students  listen.'7 

But,  my  brethren,  I  am  not  here  to-night  to  carry 
coals  to  Newcastle,  even  though  it  is  pleasant  to  try 
to  reflect  back  of  the  light  you  have  reflected  upon  us, 
but  only  with  a  few  words  to  stir  up  your  pure  hearts 
by  way  of  remembrance,  and  to  bid  3'ou  God  speed 
and  good  speed  in  this  noble  calling. 

Though  charlatans  may  wax  worse  and  worse,  and 
now  and  then  turn  even  good  men  from  the  good  ways 
of  medical  truth,  yet  it  is  a  good  clay  for  the  doctors 
after  all.  for  science  with  its  certitudes  is  aiding,  and 
our  art  with  its  successes  is  upholding  us.  Legitimate 
medicine,  as  never  before,  is  vindicating  its  claims  to 
public  recognition,  and  giving  its  votaries  their  true 
position  in  the  domain  of  culture. 

The  reaper,  death,  is  oftener  stayed,  and  waving 
life,  like  the  hill-side  harvest,  moves  gracefully  on, 
obedient  to  the  breath  of  a  new-infused  vitality.  God 
bless  us  all  in  the  work  upon  and  before  us,  and 
enable  us  to  wait  on  this  ministry  as  those  not  slothful 
in  business,  fervent  in  spirit,  serving  the  Lord. 


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